Acromegaly Presenting as Severe Hirsutism and Amenorrhea

ABSTRACT Objective: The combination of hirsutism and amenorrhea is a frequent medical complaint that is generally benign but rarely can be a sign of significant underlying pathology. Methods: Case report and review of the literature. Results: We report here a case of a 22-year-old woman who presented to medical attention due to severe hirsutism, hyperandrogenism, and diabetes mellitus. On further investigations, she was found to have acromegaly, with an elevated insulin-like growth factor 1 (IGF-1) level (662 μg/L; normal, 95 to 397 μg/L) and a growth hormone level not suppressed by a glucose challenge test. A 7 × 7 mm anterior pituitary mammosomatotroph adenoma was identified and surgically resected, resulting in normalization of her IGF-1 level and partial resolution of her symptoms. Conclusion: Increased awareness of acromegaly in the differential diagnosis of hirsutism and menstrual irregularity could promote earlier diagnosis and treatment of this debilitating and progressive condition. Abbreviations: GH growth hormone IGF-1 insulin-like growth factor 1 mFG modified Ferriman-Gallwey PCOS polycystic ovary syndrome